Going with the WHOLE grainGrains are the seeds of cereal plants and include amaranth, barley, buckwheat, bulgur, maize (corn), millet, oats, quinoa, rice, rye, spelt and wheat. These staple foods are the most concentrated source of carbs in our diet, provide us with protein, are low in fat, packed with essential vitamins and minerals and rich in fibre when you eat the wholegrain varieties. Studies around the world show that eating plenty of wholegrain cereals reduces the risk of certain types of cancer, heart disease and type 2 diabetes. In addition, a higher fibre intake, especially from whole cereal grains, is linked to a lower risk of cancer of the large bowel, breast, stomach and mouth. Although all wholegrains are healthy, nutritious foods, it’s only the low GI ones that reduce your blood glucose and insulin levels throughout the day and increase your sense of feeling full and satisfied because they are the ones that slowly trickle glucose into your bloodstream. We like to say that your body is doing the processing, not the manufacturer.

By the way, GI Group, I've got a question for you. How would you explain this ‘contradiction’? Both wholemeal bread and sweet corn contain lots of insoluble fibre but the GI of wholemeal bread tends to be high while sweet corn's GI is relatively low. Why do you think this happens?

Why do some ‘wholegrains’ have a low GI and not others? Prof Jennie Brand-Miller explainsSome people use ‘wholegrain’ and ‘low GI’ as though they are interchangeable terms. That’s not the case at all. Wholegrain foods can be high or low GI, and it’s essential to understand this and know what’s low and what’s not to manage your blood glucose levels. In fact many processed wholegrain foods such as wholemeal bread have a high GI. Why? It all comes down to the physical state of the fibre and the starch in the food. When wheat fibre has been finely divided as it is in wholemeal bread, it does little for either constipation or blood glucose levels. That’s why we say to choose your carbs carefully, and if your favourite wholegrain food has a high or moderate GI, combine it with a low GI food to reduce the glycemic load of the meal or snack. Just for the record, here are five factors that can slow digestion of those nutritious wholegrain carbs. (For tips on reducing the GI of your diet see November GI News.)

Jennie Brand-Miller

Starch gelatinisationThe starch in raw food is stored in hard, compact granules that make it difficult to digest. During cooking, water and heat expand these starch granules to different degrees – some actually burst freeing the individual starch molecules inside. If most of the starch granules have swollen and burst during cooking, we say that the starch is fully gelatinised. These swollen granules and free starch molecules are very easy to digest. The less gelatinised or swollen the starch is after cooking, the slower the rate of digestion.

Physical entrapmentThe fibrous coat around foods like beans, chickpeas, lentils, barley and seeds acts as a physical barrier. It slows down access of the digestive enzymes to the starch inside and thus slowing digestion. That’s why we say to look for lots of grainy bits when buying bread.

How much amylose starch there is in the foodAmylose and amylopectin are two types of starch found in foods, but the ratio of one to the other varies considerably. Here’s how it works. Amylose is a straight chain molecule, like a string of beads. These tend to line up in rows and form compact clumps. The more amylose a food contains, the less easily the starch is gelatinised and the slower its rate of digestion. Legumes have lots of amylose as does basmati rice. Amylopectin on the other hand is a string of glucose molecules with lots of branching points, such as you see in some sorts of seaweed. Amylopectin molecules are larger and more open and the starch is easier to gelatinise and digest. So if a food has more amylopectin than amylose, it’s going to be moderate or high GI.

Particle sizeThe larger the particle size, the lower the GI. When you eat a starchy food in ‘nature’s packaging’ – whole intact grains like barley that have been softened by soaking and cooking – the food will have a lower GI value. It’s the grinding or milling of cereals that reduces the particle size that makes it easier for water to be absorbed and enzymes to attack during digestion. That is why cereal foods made from fine flours like many breakfast cereals tend to have a high GI value.

The type of fibreThe effect of fibre on the GI value of a food depends on the type of fibre (soluble or insoluble). Soluble fibres are the gel, gum and often jelly-like components of foods like oats, legumes and apples. By slowing down the time it takes for food to pass through the stomach and small intestine, soluble fibre can lower your body’s glycemic response to a food.Insoluble fibres are dry and bran-like and often referred to as roughage. All cereal grains and products made from them that retain the outer coat of the grain are sources of insoluble fibre. But not all foods containing insoluble fibre are low GI. Why? Insoluble fibres will only lower the GI of a food when they exist in their intact, original form, for example in whole grains of wheat. Here they act as a physical barrier, delaying access of digestive enzymes and water to the starch within the cereal grain.

1. Low carb and heart health‘A heart-healthy diet should embrace healthy types of fat and carbohydrates,’ said Frank B. Hu commenting on the findings of the first study to look at the long-term effects of low-carb diets published in the New England Journal of Medicine. The researchers from the Harvard School of Public Health looked at data collected over a 20-year period from 82,802 women in the Nurses’ Health Study. They found no evidence of an association between low-carb diets and an increased risk of coronary heart disease (CHD) in women. When vegetable sources of fat and protein (see below) were chosen rather than animal sources, they report that ‘these diets may moderately reduce the risk of coronary heart disease.’ The authors highlighted a link between glycemic load and CHD. ‘A low-carbohydrate diet tends to have a lower dietary glycemic index and glycemic load than a high-carbohydrate diet,’ explained the researchers. ‘We found that the direct association between glycemic load and coronary heart disease was much stronger than the association between carbohydrate and coronary heart disease, probably because glycemic load reflects both the quantity and quality of carbohydrates.’ In a press release about the findings, Hu says: ‘This study doesn’t mean that you should load your plate with steak and bacon. One likely explanation that we did not see increased risk of CHD with low-carbohydrate diets is that the adverse effects of animal products might be counterbalanced by reducing refined carbohydrates. The quality of fat and carbohydrate is more important than quantity.’– New England Journal of Medicine (Vol. 355, pp. 1991-2002)– Harvard School of Public Health press release: www.hsph.harvard.edu

Coronary heart disease

GI Group: How much protein can you get from plants?

200 g (7 oz) of home-cooked or canned beans, lentils or chickpeas provide an average of 15 g protein

a 30 g (1 oz) serving of most nuts or seeds will deliver around 5 g protein

2. Fruit and veg – it’s a numbers gameEvery extra of fruit or vegetable consumed daily could cut the risk of heart disease by 4 per cent, says a meta-analysis of almost a quarter of a million people published in the Journal of Nutrition (Vol. 136, pp. 2588-2593). Scientists from France’s INSERM in Paris, Lille’s Pasteur Institute, and Rouen’s Department of Epidemiology and Public Health pooled nine cohort studies giving an overall study population of 91,379 men, 129,701 women, and 5,007 coronary heart disease events. They report that the risk of coronary heart disease (CHD), was cut by 4% for each additional fruit and vegetable portion consumed, and by 7% for fruit portion intake. The link between the risk of CHD and vegetable intake however was mixed with a more beneficial relationship observed for general cardiovascular mortality (26% risk reduction) than for the more specific fatal and non-fatal heart attacks (myocardial infarction) (5%).– Journal of Nutrition (Vol. 136, pp. 2588-2593)

GI Group: If you are wondering what a meta-analysis is, think of a it as being a way of looking at all the evidence statistically by integrating the results of several independent smaller studies.

PCOS prevalencePCOS is one of the most common hormonal disorders affecting pre-menopausal women and the leading cause of female infertility. Because insulin resistance is at the root of PCOS, women with it are at greater than average risk of other chronic diseases that will have a huge impact on their long-term health and wellbeing – diabetes, metabolic syndrome and heart disease. No one really knows how many women actually have PCOS. It tends to be under-diagnosed because many women consult their doctor (or doctors) about a variety of very different symptoms (See October GI News), and the dots never get joined. Figures like 5–10% are widely quoted. But this may be just the tip of the iceberg.

A new Spanish prospective study of pre-menopausal Spanish women published in Archives of Internal Medicine puts the figure at 28.3% for those who are already overweight or obese. Francisco Álvarez-Blasco, MD, of the Hospital Universitario Ramón y Cajal and colleagues recruited 113 otherwise healthy women referred by their primary physicians to an outpatient endocrinology clinic for dietary treatment. All participants were pre-menopausal, had a body mass index above 25 and were younger than 50. Of 113 women recruited, 32 were diagnosed as having PCOS, based on clinical and/or biochemical hyperandrogenism, oligo-ovulation, and exclusion of secondary causes. ‘Our results demonstrate a 28.3% prevalence of PCOS in overweight and obese women from Spain, which is markedly increased compared with the 5.5% prevalence of PCOS in lean women of our country,’ they write. But even this figure may underestimate the prevalence of PCOS as women on medications that might interfere with hormone profiles, such as contraceptives or insulin sensitisers, were excluded.

‘Physicians treating overweight and obese patients should be aware of the high prevalence of PCOS among these women,’ conclude the authors. They call for routine screening of overweight or obese women for PCOS, ‘at least by obtaining a detailed menstrual history and a careful clinical evaluation of hyperandrogenic symptoms … to diagnose PCOS and ameliorate the health burden distinctly associated with this prevalent disorder.’– Archives of Internal Medicine. 2006; 166:2081-2086

The real deal on chocolateWith Christmas and the holiday season upon us, GI News asked dietitian Alan Barclay for some tips what to do about chocolate.‘If eaten in moderation, most people with diabetes or pre-diabetes can enjoy an occasional chocolate in a well balanced diet. In fact, there is increasing scientific evidence that a little bit of chocolate each day may do you good,’ he says.

Chocolate and your blood glucoseAlthough most chocolates have a relatively high sugar content, they don’t have a big impact on your blood glucose levels. In fact the average GI is around 45 because their high fat content slows the rate that the sugars are released from the stomach into the intestine, and absorbed into the blood. So, people with diabetes don’t need to eat low, or reduced-sugar chocolates to avoid high blood glucose levels. However, alternatively sweetened chocolates usually do have fewer kilojoules – a big advantage if you are trying to lose weight.

Chocolate and your weightMost chocolates are energy dense – you get a lot of kilojoules (calories) in a little piece. This is good if you are trying to gain weight, travel long-distances with limited storage space, or participate in an endurance sport where it is an advantage to be able to carry around a concentrated and highly palatable source of carbohydrate and energy. But it is obviously not good if you are trying to lose weight. If you are overweight, buy quality chocolate and take care not to eat too much. Keep it for that occasional treat.

Chocolate and your blood fats Chocolate is high in total and saturated fats. In high quality chocolates, cocoa butter is the main source of fat. This is important, because cocoa butter is high in a particular kind of saturated fat called stearic acid. Stearic acid raises the ‘bad’ LDL cholesterol the least of the saturated fats. It also raises the ‘good’ HDL cholesterol, so the net effect on your total blood cholesterol levels is not too bad at all. However, the amount of cocoa butter used in chocolate does vary and along with it the amount of stearic acid. This information is not usually stated on the chocolate wrapper. As a very rough guide, the better quality more expensive chocolates generally have more cocoa butter and are a better choice.

Chocolate and antioxidantsChocolate is one of nature’s richest sources of a powerful group of antioxidants known as flavonoids, along with green and black tea, red wine, certain fruits (berries, black grapes, plums, apples) and vegetables (artichokes, asparagus, cabbage, russet and sweet potatoes). It’s believed that these antioxidants may benefit people with diabetes or pre-diabetes by helping to prevent cholesterol sticking to the walls of blood vessels, relaxing major blood vessels and thereby decreasing blood pressure, and maybe even reducing the ability of the blood to form too many clots. A row of dark chocolate (28 g) provides about the same amount of these antioxidants as half a cup of black tea or a glass of red wine. Milk chocolate has only one-third as much antioxidants as dark chocolate, and white chocolate has none at all.

Chilli chocolate black beansThis recipe for ‘mole poblano de laraotas negras’ is from Ian Hemphill’s The Spice & Herb Bible (Robert Rose). You need a good quality dark chocolate – one with 70% cocoa solids. If you use dried black beans, you first need to soak them overnight and cook them for about an hour.

Preheat the oven to 170ºC (325ºF). Roast chillies in the oven for 5 minutes then soak them in 2 cups (500 ml) of boiling water.

In a large pan, toast the allspice, cloves and cinnamon for 1 minute, or until their fragrance is released. Add the onions, garlic, almonds and oregano and stir until combined. Strain the chilli soaking water into the saucepan. Deseed and finely chop the chillies and add to the pan. Add the beans, chocolate and salt if you are using it and simmer gently for 45 minutes, adding more liquid if necessary.

Serve with a low GI rice or simply spoon into a warm tortilla and eat immediately.

Sumac-spiced lamb backstraps with quinoa and roasted grapesThis recipe is from The Eat Well Cookbook by Jan Purser and Kathy Snowball, which is packed with dairy free and gluten free recipes – many of which are likely to be low GI (like this one) as this cooking duo loves beans, chickpeas and lentils. Jan and Kathy are pretty passionate about good health and good food, so you will discover lots of interesting ways to incorporate legumes (pulses), gluten-free grains and quinoa into your eating plans. We love the roasted grapes touch in this recipe and the fact you can make the quinoa salad a day ahead. Sumac is that burgundy powder often rubbed on kebabs before cooking. You can buy it from specialty produce and spice shops and Middle Eastern food specialists. The Eat Well Cookbook is available in Australia and NZ from major bookstores. The US edition will be available in 2007, but in the meantime anyone can buy it off the publisher’s (Allen and Unwin) website – www.allenandunwin.com

To make Quinoa Salad, combine quinoa and stock in a saucepan, season with salt (optional) and bring to the boil over a high heat. Reduce heat to low and simmer, covered, for about 15 minutes or until the stock is absorbed and the quinoa tender. Remove lid and stir over low heat until all liquid has evaporated. Remove from heat and cool to room temperature, then stir in remaining ingredients.

Brush lamb with a little oil and rub with sumac, thyme and black pepper. Fry lamb in a non-stick frying pan until browned, then place on an oven tray. Toss grapes in a little oil and place beside lamb. Roast at 200ºC (400ºF) for about 10 minutes for pink lamb. Remove lamb and rest, loosely covered, in a warm place for 10 minutes then slice on the diagonal. Meanwhile return grapes to oven and roast for another 10 minutes or until just beginning to burst.

Top baby spinach leaves with Quinoa Salad and sliced lamb, spoon grapes and their juices over and serve with lemon wedges.

GI Express: Poached pears with rich chocolate sauceLisa Lintner’s quick and easy (it’s on the table in 30 minutes) dessert is from The New Glucose Revolution Life Plan. It’s delicious on its own or you can serve it with a dollop of reduced fat plain yoghurt or ice-cream.

Bring the water, sugar, cinnamon stick, juice and lemon rind to the boil in a large saucepan. Reduce the heat, add the pear slices and simmer for 20 minutes uncovered. Spoon the pear slices into a serving bowl or individual dishes using a slotted spoon.

While the pears are simmering, make the chocolate sauce by placing all the ingredients in a small saucepan. Heat gently, stirring occasionally. When combined, drizzle over the pears and serve.

Avoiding complications – Marianne‘About 10 months ago I was diagnosed with type 2 diabetes and high cholesterol. I had been overweight for most of my life and have been treated with medication for hypertension for 20 years. I searched the Web for a nutritional plan to help me lose weight. As a nurse I knew I craved carbohydrates, especially bread. I came across the plan for glycemic index and have followed it since then. So far I have lost over 30 pounds. I visited my physician after six months of weight loss and my cholesterol levels and glucose levels (HbA1c) were all the normal range. When I see my physician next month she wants to stop my diabetes medication. I exercise every day and feel so much better. I have a lot more energy, I sleep better, and I actually enjoy going out with my friends and family. I hope to lose more weight and avoid any complications from my diabetes, high cholesterol, and hypertension.’

Preventing diabetes – JasonI've been overweight most of my life. I remained overweight after becoming a vegan in 1994. I've had diabetic symptoms such as chronic pain and fatigue in the arches of my feet since I've been 18, and occasionally constant thirst, and frequent urination. When I got blood cholesterol panels tested, it always came back with the same results: Normal total cholesterol, high triglycerides and low HDL. My doctors always told me to lose weight and exercise more, but I could never lose the weight permanently. In the summer of 2004, I once again had a cholesterol panel blood test. Once again the results were the same, high triglycerides and low HDL. I looked up the symptoms in the Dr. Weil website. It says high triglycerides, low HDL and weight concentrated around the mid-section (the classic apple shape, which was how I looked), were symptoms of insulin resistance. There was another article that recommended eating lower on the GI index. That information led me to the website and books. After a few days after adopting a low GI diet to my vegan diet my foot pain was gone. I started to lose weight immediately. After a few months I was down to 140 pounds from the 160s. The symptoms of insulin resistance in my follow-up blood test were greatly diminished. Today my BMI is 22. I really do believe the information in your books and web site saved me from diabetes and heart disease. I have no hesitation in recommending the GI website and books to friends and family. Merry Christmas.

Inspire others. Share your GI story.

We'll send you a free copy of The Low GI Diet Cookbook if your story is published.

The Spice and Herb Bible by Ian Hemphill with Kate HemphillPublished by Robert RoseIan Hemphill wants us all to enjoy the world of spices and herbs. It is the driving force behind this second and now fully illustrated edition of The Spice and Herb Bible. With growing evidence of the role spices like cinnamon, chilli, turmeric can play in blood glucose control, GI News asked Ian to give us some simple suggestions for spicing up your meals. Here are his tips.

Ian Hemphill

‘Many people are under the impression that healthy food is not tasty, however this can be changed with the addition of just a little spice. Most spices are not hot or even strong, so anything between one and two teaspoons to approximately 500 g (1 lb 3 oz) of the meal to be flavoured, will do the trick. The following spices will all compliment low GI carbs.’

Cinnamon goes particularly well with porridge and any non-savoury dishes. Add during cooking so the flavour amalgamates effectively.

Beans (red kidney, borlotti, black-eyed, soy and chickpeas) are all greatly enhanced by adding equal proportions of paprika, turmeric and ginger. For those who like a bit of heat, add a pinch of chilli powder as well.

Delicious South Indian flavours can be created with most vegetables by adding a little turmeric and ginger with a pinch of ground cardamom seed. For added interest and freshness, also include some fresh coriander leaves and curry leaves.

The Middle Eastern spice sumac compliments salads, avocado and is brilliant on tomatoes that have been slow-roasted. Sumac is one of the easiest condiments to add, as it does not need to be cooked into the meal and may be simply sprinkled on when served.

Published in North America and the UK by Robert Rose as a fully illustrated trade paperback.Published in Australia by Macmillan as a hardback (Spice Notes and Recipes).

Prof Jennie Brand-Miller's The Low GI Vegetarian Cookbook is now available in the UKPacked with delicious recipes and illustrated with mouthwatering photography, this book by the world authorities on low GI eating shows you how to combine the basics of healthy vegetarian or vegan eating with low GI carbs. There are seven-day menu plans for vegetarian and vegan adults, teenagers and children plus 80 easy-to-follow recipes to delight your tastebuds and nourish your body. Start eating yourself healthy today.

Any thoughts on juicing? My husband (he has type 2 diabetes) and I generally have fresh juice in the mornings. We have noticed that his sugar readings are higher than usual and I am wondering if the juice is having an adverse effect. Many websites seem to indicate that diabetics shouldn't juice because there is no fiber to slow the assimilation of the sugar.GI Group dietitian Kate Marsh says: ‘Definitely moderation when it comes to drinking juice – although many juices have a low GI, they also have a relatively high GL due to the amount of fruit it takes to make a glass of juice. I suggest making a combined fruit and vegetable juice as there is obviously less sugar/carbs in the vegies. Alternatively, dilute the fruit juice with water or mineral water. Remember it’s all too easy to overdo the calories (kilojoules) with juice – a serving is a small glass which if you measure it out is just ¾ of a cup (7 fl oz/200 ml).’

What should the daily glycemic load be held below for a diabetic?As we said in November GI News, we recommend you use the GI, rather than GL so we don’t suggest a GL number to shoot for. This is because a low GL diet can either be low GI and high in carbohydrates; or high GI and low in carbohydrates, and have similar effects on blood glucose levels, but significantly different effects on blood fats and insulin sensitivity. Emphasis on GL could easily lead to an unhealthy diet based on too few carbs. If you concentrate on foods/meals with a low GL, you could well end up eating a diet that is too low in carbs and too high in saturated fat. Fatty meats like salami and bacon and cheese after all have a low GL. If you choose healthy low GI foods – at least one at each meal – chances are you’re eating a diet that not only keeps blood glucose within the healthy range, but contains balanced amounts of carbohydrates, fats and proteins.

With the festive season upon us, do you have some tips for people with diabetes to help us stick to our healthy eating and exercise routines at family and social events when overindulgence is the order of the day?Christmas, birthdays, entertaining, celebrations, parties – all of these events have one thing in common: food, and in particular, food that’s out of your control. The key is to try to keep your celebratory eating distinct from your regular meals rather than letting the entire Christmas period become a time of gorging and indulgence. And let people know if you don't want food as gifts, especially chocolates, lollies. Here are some tips from dietitian Kaye Foster-Powell for successful socialising.

Don't arrive hungry. Have a small healthy snack before you go to parties to reduce the chance you'll overeat.

Don't stockpile your plate. It’s not a siege. If it’s a buffet, take one or two items and come back for more if you are still hungry.

Adopt a pastry-free policy. By simply avoiding one of the most calorie/kilojoule-laden party foods, you'll be ahead.

Talk more, eat less and move away from the table.

Take to the dance floor to burn up some or all the excess energy.

Alternate alcoholic and non-alcoholic drinks, use small wine glasses and fill your glass and only when it's empty.

If you eat dessert, eat less carbohydrate (starch, fruit, milk) at that same meal. Or, learn to adjust your short or fast acting insulin for larger portions.

When you are the host:

Only buy and prepare as much food as you need

Let your guests know that there’s no need to bring any food. Or, if it is a tradition that everyone contributes something to the festivities, specify exactly what you would like them to bring.

Freeze leftovers as soon as possible to make it harder to pick at them while you are cleaning up. Better still, give leftovers to guests when they leave or donate them to a charity that feeds underprivileged or homeless people.

I would like to make some low GI bran muffins, but I don't know what type of flour to use (that I can buy at the grocery store). Any suggestions?To date there are no GI ratings for refined flour whether it’s made from wheat, soy or other grains. What we do know, however, is that bakery products such as scones, cakes, biscuits, donuts and pastries made from highly refined flour whether it’s white or wholemeal are quickly digested and absorbed. What should you do with your own baking? Try to increase the soluble fibre content by partially substituting flour with oat bran, rice bran or rolled oats and increase the bulkiness of the product with dried fruit, nuts, muesli, All-Bran or unprocessed bran. We don’t have a plain bran muffin recipe, but there are numerous muffin recipes in Jennie Brand-Miller's GI books and most contain some bran. The ‘Mixed Berry Muffins’ pictured here from The Low GI Diet Cookbook are delicious and have about a cup of bran in them as do the low GI ‘Oat & Apple Muffins’ (recipe below) from The New Glucose Revolution.

To make:Combine the All-Bran and milk in a bowl and let stand for 10 minutes. Sift the flour, baking powder, and mixed spice into a large bowl. Stir in the oat bran, raisins, and apple. Combine the egg, honey, and vanilla in a bowl. Add the egg mixture and All-Bran mixture to the dry ingredients and stir with a wooden spoon until just combined. Do not over mix. Spoon the mixture into a greased 12-hole muffin tray. Bake in a moderate oven (180°C/350°F) for about 15 minutes or until lightly browned and cooked through. Serve warm or cold. Makes 12 muffins

Do you have any prepared menus for breakfast, lunch and dinner?When it comes to menus one size doesn’t fit all, so we don’t have them on our site at this stage. There are menus with an emphasis on low GI foods designed for people with specific needs from diabetes and heart disease, to PCOS, weight loss or wanting to follow a vegetarian diet in Jennie Brand-Miller’s GI books. For example, if you are just after some low GI healthy eating plans, you might like to check out Low GI Eating Made Easy, which includes the top 100 low GI foods and ways to enjoy them. Or the New Glucose Revolution Life Plan where dietitian Kaye Foster-Powell provides four typical healthy low GI menus for ‘EveryBody’, ‘BiggerBodies’, ‘BusyBodies’ and ‘KidsBodies’. There are vegetarian and vegan menus created by dietitian Kate Marsh in The Low GI Vegetarian Cookbook and a 12-week weight loss plan in The Low GI Diet. If you have special dietary needs, we suggest you consult a registered dietitian. He or she will have the letter RD (US/Canada) or APD (Australia) after their name.

How many carrots does it take? When you test GI do you use 50 g weight or 50 g as a unit of energy i.e. 50 g of CHO = 200 Kcals. If so, how do you test carrots? You must leave fibre out, so that seems like an awful large bunch of carrots to make someone crunch through.Great question. When we test at SUGiRS, we calculate the quantity of a particular food necessary to deliver 50 grams of digestible carbohydrate (we don’t count the grams of fibre in this). If this represents an unreasonably large amount of food, we scale down everything by half and test a 25 gram carbohydrate portion. In fact, all the fruits and many vegetables, including carrots have been tested in this way, including carrots. In the case of carrots, the subjects ate about 350 g cooked carrots (about 3–4 large carrots). It was a large portion but manageable! In the case of raw carrot juice, they consumed about 350 ml (easy!). The resulting GI values (41 and 43 respectively) show that carrots, cooked or raw, have a low GI. Because all fruits and vegetables (bar potatoes!) are valuable additions to the diet, we don’t dwell on their GI. With the exception of potatoes, we recommend you eat them all to your heart’s content.

The following fruit juices are a combination of 99% fruit juice with an added dash of vitamins, herbal or botanical extracts. There’s no added sugar. The available carb and GL figures here are based on drinking one small glass (200 ml/7 fl oz) which is equivalent to one delicious serving of fruit.

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Success Story—‘I am so pleased with the results of a low GI diet I want to share my experience.’

What's New?—Shopper’s Guide to GI Values 2007, new editions for the US and ANZ

Feedback—Your FAQs Answered

Is there a way I can change a bad carb like potatoes into a good carb?

Should I use the GI or GL when planning meals?

I recently became a diabetic and was given a very brief course in nutrition to help me manage my glucose levels – without much success. Which of your books would help me?

Can I estimate a food’s GI by looking at the ingredient listing or nutrition label?

Have you done a study on winter squashes (pumpkins)?

GI Values Update—Many of the products in GI Values Update are not available in the USA. Why’s that?—The latest GI values from SUGiRS

The publishers of the New Glucose Revolution series, Hachette Livre Australia, Hodder Mobius UK and Marlowe & Company New York, have agreed to give away a copy of The Low GI Diet Cookbook to every 1000th subscriber from now on. To subscribe, just click on 'SUBSCRIBE' at the top of the right-hand column. Every 1000th subscriber receives a complimentary copy of The Low GI Diet Cookbook. Books for subscribers 20,000 and 21,000 went to Dubai and Catasauqua, Pennsylvania respectively.

The lowdown on reducing the GI of your dietGI critics tend to say that understanding the glycemic index and putting it into practice is too complicated for the average person. It makes you wonder if they’ve ever tried, if they actually know what they are talking about, if they have another agenda, if they are being mischievous or all four? Earlier this year (March GI News) US dietitian Johanna Burani reported the results of a small study of people with diabetes who, simply given the basics, found it well within their grasp to incorporate low GI carbs into their diet to help keep their blood glucose on an even keel. So, this month we share the practical tips our GI Group dietitians give their clients to make the switch to low GI eating. There’s no specific order. Essentially, they suggest that you attack the changes that you think you’ll find easiest first – nothing is quite so inspiring as success. And that you make changes gradually – it can take 6 weeks for a new behaviour to become a habit. Here’s how you can get started.

Pile half your dinner plate high with green or salad vegetables. Aim to eat at least five serves of vegetables (this doesn’t include starchy the ones like potato and sweet potato) every day, preferably of three or more colours.

If you are a big potato eater and can’t bear the thought of giving them up, you don’t have to. Just cut back on the quantity (right back). Either have one or two tiny chat potatoes with a small cob of corn or make a cannellini bean (they are white beans) and potato mash replacing half the potato with cannellini beans. And try other starchy vegetables occasionally like sweet potato, yams or taro – steamed, roasted or mashed.

Swap your bread. Instead of high GI packaged white and wholemeal breads, choose a really grainy bread where you can actually see the grains, granary bread, stone-ground wholemeal bread, real sourdough bread, soy and linseed bread, pumpernickel, fruit loaf or bread made from chickpea or other legume based flours.

Replace those high GI crunchy breakfast flakes that spike your blood glucose and insulin levels with smart carbs like natural muesli or traditional (not instant) porridge oats or one of the lower GI processed breakfast cereals that will trickle fuel into your engine.

Learn to love legumes – home-cooked or canned. Add chickpeas to a stir-fry, red kidney beans to a chilli, a 4-bean salad to that barbecue menu, and beans or lentils to a casserole or soup.

Develop the easy art of combining. No need to cut out all high GI carbs. The trick is to combine them with those low GI tricklers to achieve a moderate overall GI. How? Lentils with rice (think of the classic Italian soup), rice with beans and chilli (go Mexican), tabbouli tucked into pita bread (with felafel of course and a dash of hummous), baked beans on toast or piled on a jacket-baked potato for classic comfort food.

Incorporate a lean protein source with every meal – lean meat, skinless chicken, eggs, fish and seafood, or legumes and tofu if you are vegetarian. Your protein portion should make up around a quarter of your dinner plate.

And remember portion caution with carb-rich foods such as rice, al dente pasta and noodles, potatoes etc. Eating a huge amount of these foods, even of the low GI ones, will have a marked effect on your blood glucose. A cup of cooked noodles or al dente pasta or rice plus plenty of mixed vegetables and a little lean protein can turn into 3 cups of a very satisfying meal.

It’s really not hard. Be encouraged. Many people who write to us after making the switch to a low GI diet tell us how easy and enjoyable they find it. They love the fact that meals have gotten a whole lot more interesting because they are eating a wider variety of food and they are over the moon about having more energy, keeping their blood glucose on an even keel and feeling well. Our ‘success story’ this month is a great example.

What’s best for baby?Being born big is not better when it comes to babies. We now know from a number of studies that a baby’s birth weight can set the pattern for life, predicting long-term risk of obesity and chronic disease. A new study published in the American Journal of Clinical Nutrition suggests that the GI of the mother’s diet during pregnancy may be another important key to producing a healthy weight baby who will grow up to be a healthy child and adult. The study compared the effects of two diets on 62 healthy pregnant women. The overall quality of both the diets was good, with food and nutritional intakes in line with recommendations for pregnant women. Lead researcher Dr Robert Moses writes that the babies of the mothers eating the low GI diet were of normal size, but were smaller and had less body fat than the babies of the mothers eating the moderate–high GI ‘high fibre-low sugar’ diet during the pregnancy. Interestingly, the women in the low GI group were more likely to report that they found the diet easy to follow than the women in the high fibre-low sugar group. One of the researchers, Prof Jennie Brand-Miller, told GI News that: ‘I think the most important take home message from the pregnancy study is that the GI appears to have a more important effect on birth weight than any single dietary factor, including amount of protein, fat or amount or carbohydrate.’– AJCN 2006;84:807–12

Eat to beat acneA diet rich in lean protein and low GI carbs can improve acne by 50 per cent in 12 weeks or less according to researchers from Australia’s RMIT University. These results are similar to that seen in published trials with successful topical therapies. The group presented their findings at the European dermatology conference in Greece in September. The detailed article describing the study methods and results is currently being peer reviewed and will be published in a scientific journal in 2007.

For the 12-week trial, 43 teenage boys with moderate to severe acne were randomly assigned either to a low GL (45% carbohydrate and 25% protein) diet including low GI carbs and lean protein or the control diet including carb staples with a moderate to high GI. Each boy was given an individualised dietary plan along with some training in using food scales and keeping food records. Low level acne skin wash was standardised for all the boys and their acne was assessed every four weeks by an expert dermatologist who did not know the dietary group of the subjects. According to lead researcher Dr Neil Mann, ‘the acne of the boys on the higher protein-low GI diet improved by more than half. This diet reined in the high insulin levels that could be responsible for acne. When you go through puberty you produce a lot of growth hormone that actually makes you temporarily insulin resistant. In conjunction with a high glycemic load diet common in western societies this causes chronically high insulin levels. With such high levels of insulin you're going to get blockages in the pores and extra oil building up under the skin. A diet high in processed foods pushes glucose and insulin levels higher, exacerbating the problem, but low GI foods do the opposite. Low GI carbohydrates and lean protein-rich foods help to reduce insulin levels that affect the hormones associated with acne.’

Macronutrient composition of the low GL diet

What hormone's that?Acne is formed when the sebaceous gland (oil gland) produces extra sebum (oil). At the same time the gland becomes blocked due to cells lining the follicle duct expanding under the action of insulin related growth factors such as IGF-1. This causes a build-up of sebum within the gland which gets bigger. As a result bacteria grow within the gland and eventually bursts causing inflammation and redness. The main hormones that play a role are:

Androgens (male hormones)When the levels of active androgens increase it causes more oil to be produced within the gland.

Fill up not out with low GI lentilsIf you have diabetes, lentils are one food you should learn to love – you can eat them until the cows come home. In fact, our dietitians report that no matter how much of them you eat, they have only a small effect on your blood glucose levels. But lentils are ideal for everybody, not just people with diabetes. Rich in protein, high in fibre and packed with nutrients like B vitamins, folate and minerals, this little nutritional giant fills you up – not out. They are also gluten free, easy to prepare (no soaking), quick cooking (15–20 minutes) and inexpensive (so great for feeding the family). All colours and types of dried lentils have a similar low GI value. Although opting for handy canned convenience increases the GI somewhat, lentils are still a very smart carb choice.

GI 26 (red, home cooked)

GI 30 (green, home cooked)

GI 52 (green, canned)

photo: Ian Hofstetter

Low GI eating made easy with canned or home-cooked lentils

Up the nutritional ante and thicken sauces and salsas with pureed lentils. If it’s a new taste sensation for your family, add just a little for starters until their palates adjust to the slightly earthier flavour.

Transform a simple tomato soup into something substantial by adding a cup or two of lentils – whole or pureed if it’s a creamy style soup.

Extend a stew or casserole with a cup or two of lentils. Great to help the leftovers feed the whole family.

Whip up a salad in seconds with lentils, tuna, chopped red capsicum and finely chopped red onion, tossed in an oil and red wine vinegar dressing.

Toss buckwheat noodles with lentils and blanched broccoli in a dressing of olive oil and white wine vinegar mixed with a little crushed garlic and finely grated ginger.

Mad about mash? For an easy (and lower GI) alternative to mashed potato, bring to the boil 250 ml of reduced salt chicken or vegetable stock, 2/3 cup of split red lentils and 1 bay leaf, then simmer until the lentils are mushy and thick. Season with freshly ground black pepper and your favourite herbs or spices.

Feel like a burger? Process a 14 oz (400 g) can of drained lentils in the food processor for a second or so until they look like coarse breadcrumbs. Soften a chopped onion, a clove of garlic crushed and a grated carrot in olive oil for a few minutes in a frying pan. In a bowl thoroughly combine the lentil ‘crumbs’ with 1/3 cup (40 g) sunflower seeds, 1/2 cup (50 g) rolled oats and ½ cup (40 g) wholegrain breadcrumbs and a dash of chilli or soy sauce (or both). Form into 4 patties, chill in the refrigerator for an or so until firm, then and cook 3–4 minutes a side on the barbecue or in a pan.

Still short on ideas for what to do with beans, chickpeas and lentils?For starters you may like to take a look at a copy of The Pea and Lentil Cookbook - From Everyday to Gourmet from the USA Dry Pea and Lentil Council. It has around 150 recipes (we'll give you a taste in the coming months), many of them photographed plus a nutritional analysis for each (not GI though). It's fun to read just for the tips on every page. You can order a copy from their website (www.pea-lentil.com) or email them for more information (pulse@pea-lentil.com).

Another source of ideas is the Saskatchewan Pulse Growers' Discover the Pulse Potential. There are around 100 recipes from appetisers and salads to soups and desserts each with a nutrient analysis (but not a GI rating). We’ll give you a taste over the next year (with a GI rating). It addresses special dietary concerns such as diabetes and celiac disease and provides information on pulse varieties and how to cook them. You can order a copy from www.amazon.ca or contact Saskatchewan Pulse Growers, 104–411 Downey Road, Saskatoon, SK S7N 4L8 CanadaEmail: pulse@saskpulse.com

The recipes this month come from The Low GI Vegetarian Cookbook. The book is available in Australia now and will be published (the publishers say) in the US and UK in November and December respectively.

Heat 2 teaspoons of the oil in a small non-stick frying pan over medium–high heat. Add the asparagus and corn. Cook for 2–3 minutes or until vegetables are just tender. Remove from heat. Stir in the parsley. Season well with pepper.

Use a fork to whisk the eggs with 2 tablespoons of water. Heat 1 teaspoon of the remaining oil in the frying pan over medium heat. Pour in half of the egg mixture and cook for 3 minutes or until almost set, using a fork to pull the cooked egg away from the edges and allow the uncooked egg to run to the edges.

Sprinkle half the asparagus and corn mixture and half the Parmesan over half of the omelette, and fold over to enclose. Lift out carefully and set aside.

Repeat with the remaining egg mixture and filling. Spread each piece of toast with avocado, and serve with the omelette.

If you have two small frying pans, you can cook both omelettes at the same time.

‘I am so pleased with the results of a low GI diet I want to share my experience’ – Robert You may think I am being premature in writing like this but I am writing to say thank you for the existence of the low GI diet and all the researchers and others who have made it accessible through the books you publish and the database you provide.

I had been unwell for some time and in the week of 27th June I was hit by what I call a ‘metabolic storm.’ I was admitted to hospital with a BGL in excess of 33.3 mg/L and was diagnosed with type 2 diabetes, although I was on an insulin drip followed by insulin injections for most of my hospital stay. While I was in hospital my wife obtained The New Glucose Revolution and The Low GI Diet Cookbook, which I read avidly.

When I left hospital I was on Gliclazide plus the usual dietary control. My endocrinologist suggested that given this was likely to have been a long-term problem BGL in the range 6–10 would be a good range for me. I accessed your website, signed up for the newsletter and browsed the database. The two books became my food bibles and I followed the suggested regime ruthlessly. Within two weeks I was in trouble with my BGL being driven too low, I got down to a BGL of 3.1 and frankly anything below about 5 did and does tend to give me a bad case of the shakes. So, Gliclazide was stopped and from then on I have relied entirely on dietary control. My endocrinologist says I only really need to check my BGL several times a week or if I suspect there is a problem, but part of my regime is consistency, meals at a regular time, plan ahead, check what is happening. Following is some data to illustrate the results:

Click to enlarge

I firmly believe this has been achieved by the resources that you provide, and that I would not be where I am today without them.

Send Us Your Success Story!

We'll send you a free copy of The Low GI Diet Cookbook if your story is published.

A shopping list of low GI essentials to make shopping quicker and healthier

A guide to eating out and the healthiest takeaway food options

Available in Australia and New Zealand (Hachette Livre Australia) November 2006 and in the US (Marlowe & Company) December 2006.Back in stock: Peter’s Howard’s Delicious LivingNew Holland Publishers AUD$19.95

We reviewed this title back in June, but a number of readers have reported that they found it hard to get a copy. The good news is that it is now back in stock in book stores Australia wide. The book of 60 plus recipes was written to help people manage their diabetes and enjoy good food at the same time. It is endorsed by Diabetes Australia.

Is there any way I can change a bad carb like potatoes into a good carb? Or mellow a bad carb’s effects?We tend not to talk good carbs bad carbs. We think it is more a question of balance. While you’ll benefit from eating healthy low GI carbs at each meal or for snacks, this doesn’t have to be at the exclusion of all others. High GI, carb-rich foods such as potatoes, wholemeal bread and brown rice make a valuable nutritional contribution to your diet. And when you combine them in a meal with low GI carbs such as lentils or beans or protein foods such as a piece of steak or fillet of fish, the overall GI value of the meal will probably be medium. See our tips for reducing the GI of your diet in Food for Thought this month. And if you love potatoes as so many people do, start by cutting back on the quantity. Either have one or two tiny chat potatoes with a small cob of corn, or make a cannellini bean and potato mash replacing half the potato with cannellini beans, or enjoy a small portion of potato salad with a vinaigrette dressing.

Should I use the GI or GL when planning meals?We are often asked this. We recommend you use the GI, rather than GL, to identify your best carbohydrate choices. Emphasis on GL (ie GI x the amount of carbohydrate in the food) could easily lead to an unhealthy diet based on too few carbs. Some health professionals have unwittingly recommended the use of GL in place of GI on the basis that GL gives the best impression of a food’s overall effect on blood glucose levels. A few foods, for example, have a high GI but a normal serving of the food has a low GL (eg watermelon). That might well be true but it’s not a good reason to concentrate exclusively on the GL. Here’s why.

Carbohydrates with a low GI have a lot more going for them than simply keeping blood glucose levels on an even keel. Slow carbs, as we call them, are digested and absorbed slowly throughout the length of the small intestine. This makes them more likely to be filling and to stimulate the brain-gut peptides that spell ‘satiety’. Low GI carbs are also far more likely to be healthy foods such as legumes, fruits and dairy products that make a positive contribution to health in many ways (not just lowering blood glucose levels).

If you concentrate on foods/meals with a low GL, you could well end up eating a diet that is too low in carbs and too high in saturated fat. Fatty meats like salami and bacon and cheese after all have a low GL. Although the GL concept is useful in scientific research, it’s the GI that’s proven to be most helpful to people day-to-day, say our dietitians. If you choose healthy low GI foods – at least one at each meal – chances are you’re eating a diet that not only keeps blood glucose within the healthy range, but contains balanced amounts of carbohydrates, fats and proteins.

I recently became a diabetic and was given a very brief course in nutrition to help me manage my glucose levels – without much success. Which of your books would help me?Many people with diabetes struggle to keep their blood glucose on an even keel and lose weight – and not just when they are first diagnosed. It’s ongoing. That’s why it’s really important to see a registered dietitian who specialises in helping people with diabetes. It can really make a real difference long term. Your family doctor should be able to recommend one. As for books, we usually suggest Low GI Eating Made Easy for starters. It’s very practical and an easy read. It covers making the change to low GI eating in easy steps and lists the top 100 low GI foods and ways to include them in your diet. There’s also a week of low GI eating – breakfast, lunch, dinner and dessert ideas and the GI tables. If you want a bit more of the science behind the GI, check out The New Glucose Revolution Low GI Guide to Diabetes. You can get these books from Amazon and major booksellers.

Can I estimate a food’s GI by looking at the ingredient listing or nutrition label?We are often asked this question. And the simple answer is that you can’t ‘work it out’. A packaged food’s Nutrition Facts panel will tell you the carbohydrate content, but it won’t indicate the GI of that food. If it contains at least 10 grams of carbohydrates per serving, you can be sure it will have at least some effect on your blood glucose concentration – but there’s no way of telling whether it will be a little or a lot. Similarly, you can’t estimate the GI of a food by looking at its ingredient list, because it won’t tell you the final state of the starches in the food – which ultimately determine GI value.

However, you can make some generalisations about the GI of different foods that you can keep in mind when shopping. Legumes, for example, have some of the lowest GI values whether you buy them dried or canned, it doesn’t matter about the brand. Most pasta and noodle products tend to be low GI foods too as are most fresh fruits and dairy foods like milk, yogurt, ice cream, and custards. In contrast, most bread, bakery products, rice and breakfast cereals are high GI, although those that are less processed may be lower GI. Protein-rich foods—cheese, meat, eggs, and poultry – don’t have measurable GI values, because they contain little if any carbohydrates. The same is true for salad vegetables. Check out the database at www.glycemicindex.com for the most comprehensive list of GI values available. If you want something portable, you might like to pick up The New Glucose Revolution Shopper’s Guide to GI Values. It is updated each year, so look for the 2007 edition which should be published around November/December. And hound the manufacturers of your favourite foods to have them glycemic index tested ‘in vivo’ (that means what happens in real people not in a glass test tube) following the standard international procedure.

Have you done a GI study on winter squashes (pumpkins) such as hubbard, acorn, butternut etc? There’s only been one published result for winter squash (it is listed as pumpkin) and it had a high GI (75). The actual variety tested isn’t given. But a typical serving of say 80 grams cooked winter squash is only going to have around 5–6 grams of carbohydrate, so the glycemic load will be quite low. That’s why we classify these healthy vegetables like winter squash and swedes etc. as ‘everyday caution with portion foods’ as we want people to eat plenty of vegetables (at least five servings a day) on a low GI diet. It’s only the starchy, carb-rich potato with a high GI that we suggest people cut back on.

Many of the products in GI Values Update are not available in the USA. Why’s that?The answer is pretty simple. Very few US companies are GI testing their products, and those that are don’t always release the results for publication. Where do the values we publish in GI News come from? We publish the GI values of foods that have been tested by a lab that provides a legitimate GI testing service following the standardised in vivo procedure – and currently there are only a few centres around the world that do this. We also need the manufacturer to give us permission to publish the results. And they don’t always do this. We really do understand how frustrating it is not to be able to find the GI of your favourite foods. We always urge people to hound manufacturers to get their foods GI tested. But we also know that’s much easier said than done, especially when you use the ‘HOW TO CONTACT US’ page on that corporate website. Following a recent press release that was published internationally, we asked Kraft in the US for a few more details about a new ‘healthy’ range of snacks and cereals that they are promoting. We filled in all the ‘compulsory (asterisked) fields, so they probably now know more about us than we do about their products.

GI Group: ‘Have you glycemic index tested your ‘Back to Nature’ granolas, cereals, cookies and crackers? Are any low GI? Are any gluten free? If not do you plan to GI test these products in future?’

Kraft: ‘Thank you for visiting www.kraft.com/responsibility. Unfortunately, we don't have that information available at this time. If you haven't done so already, please add our site to your favorites and visit us again soon!’

Don’t despair. Keep hounding and together we will make a difference. It just may take a bit of time. And please tell us about products you know have been GI tested by an accredited laboratory. The takehome message: Enjoy plenty of the foods that are naturally low GI (legumes/pulses, fruit and vegetables, pasta and noodles, reduced fat dairy foods). To find out more about them, you might like to check out a copy of Low GI Eating Made Easy which has a whole section on the top 100 low GI foods you can tuck into without worrying about brands.The latest GI values from SUGiRS

Fiona Atkinson

These super tasty breakfast cereals now on the shelves in Australian supermarkets had to be kept under lock and key during GI testing reports Fiona Atkinson from the SUGiRS team.

For nutrition and product information from the manufacturer, check out www.vogels.com.au for the Vogels products and www.specialtycereals.com.au for the Wild Oats product.

For information on nominal serve sizes, available carbohydrate and glycemic load, check out the GI database at www.glycemicindex.com

GI Symbol Program NewsAustralian health bread specialist, Country Life Bakery has created a low GI gluten-free loaf. This ground-breaking product will be welcomed by all those in Australia who need to eat a gluten-free diet and keep their blood glucose on an even keel.

What does the GI symbol mean?The GI symbol on a food is a guarantee that the stated GI value is reliable and that the food is a healthy choice in its food group. To earn certification, foods that carry the symbol must be a good source of carbohydrate and meet a host of other nutrient criteria including kilojoules (calories), total and saturated fat, sodium (salt), and where appropriate, dietary fibre and calcium. The GI Symbol Program is a public health initiative run by Glycemic Index Limited, a non-profit company whose members are the University of Sydney, Diabetes Australia and the Juvenile Diabetes Research Foundation.